The Section 1135 Medicaid waiver grants the state’s Agency for Health Care Administration (AHCA) and Department of Health (DOH) more flexibility in eliminating administrative burdens and expanding access to needed health-care services.
The AHCA manages Florida’s $30 billion Medicaid budget and 17 managed care plans that provide safety-net health programs for nearly 4.2 million low-income state residents.
“Florida is acutely focused on eliminating unnecessary barriers on our health-care providers who are on the front lines serving our communities most impacted by COVID-19,” Gov. Ron DeSantis said of the state’s plan, which loosens requirements in Medicare, Medicaid and Children’s Health Insurance Program (CHIP) services, or KidCare, which provides medical insurance for 2.4 million Florida children who don’t qualify for Medicaid.
Meanwhile, Democratic U.S. Reps. Stephanie Murphy, Kathy Castor and Donna Shalala have called on DeSantis to “revisit” Medicaid expansion in response to the coronavirus outbreak.
Florida annually secures federal funding for a Low Income Pool (LIP) that delivers health-care services to the underinsured/uninsured under a 2005 CMS waiver.
Since the Affordable Care Act (ACA) was signed into law in 2010, Florida remains one of 14 states that have not expanded Medicaid under the ACA despite several failed efforts to do so.
In 2013, state lawmakers implemented a Managed Medical Assistance (MMA) program. In 2017, Florida received approval from CMS to extend all portions of the MMA Waiver, including the LIP program, through June 30, 2022.
The approval from CMS allows the state to continue operating the MMA program while increasing the LIP to $1.5 billion annually.
“Nothing has highlighted how important it is for Fla. to expand Medicaid more than the threat posed by #coronavirus,” she wrote in a Tuesday tweet. “In the midst of this public health emergency, I’m leading a call to state leaders to put people over partisan politics & finally expand Medicaid.”
Murphy joined Florida congressional Democrats, including Alcee Hastings, Debbie Mucarsel-Powell and Debbie Wasserman Schultz, in calling on CMS to extend the 2020 enrollment period for individuals to sign up for health coverage under the ACA. It closed Dec. 15.
Florida’s Section 135 waiver approval letter from the CMS enables the state to waive prior authorization requirements to needed services, streamline provider enrollment processes, allow care to be provided in alternative settings, suspend some nursing home screening requirements to provide administrative relief, extend deadlines for appeals and state fair-hearing requests and allow the AHCA to waive some fees and background checks for newly enlisted health care providers.
“I want to thank Gov. DeSantis for his leadership in Medicaid and for taking full advantage of federal flexibilities,” CMS Administrator Seema Verma said in a statement. “CMS is committed to removing all unnecessary administrative and bureaucratic barriers that may hinder an effective response to this public health emergency, and I have directed my team to expeditiously process these requests.”